@OuzounianMD We more aggressively enlarge the annulus. Target: Female 23mm prosthesis, male 25mm. Many patients in Germany want to avoid Warfarin, they rather risk redo procedures or VIVIVIV. #tssmn#adultCS
@drnikkistamp I think, the extend is often a question. Do I have to do the arch, you are running out of time for playing in the root area. #tssmn#adultCS
@OuzounianMD@drchrismerry@drnikkistamp@ritamilewski We directly cannulate the ascending aorta and resect the cannulation site in HCA. By using a AnteFlo prosthesis (prosthesis with one 8 mm perfusion branch), early reperfusion can be initiated easily without leaving a "culprit lesson" at the aorta.
@OuzounianMD I think, we just got the tip of the problem. We still cannot differ between valve diseases affecting the aorta and aortic diseases affecting the valve. #tssmn#adultCS
@OuzounianMD Embryologically, the proximal arch is originating from the neural crest as well. Thus, we extend into the proximal arch much more aggressive than some years ago. #tssmn#adultCS
@OuzounianMD Studies from Girdauskas and Borger have shown that BAV stenotic valve have the same risk of aortic dilation than TAV stenotic valves. #tssmn#adultCS
@drchrismerry#tssmn#adultCS Well, wall thickness is a quite soft variable. Difficult to define and often differently interpreted. Not really useful for guidance.